Provider First Line Business Practice Location Address:
GENESIS PT AND WELLNESS, PLLC
Provider Second Line Business Practice Location Address:
4428 MAIN STREET SUITE 100
Provider Business Practice Location Address City Name:
DALLAS
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
75226
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
214-631-9812
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
06/26/2020